Most Relevant Information
Provider Data
| NPI Number: | 1003545773 |
| Provider Name: | STEPHANIE MACKLIN |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 0010-12297 |
Most Important Dates
| Enumeration Date: | 06/08/2022 |
| Last Updated: | 05/15/2023 |
Provider Practice Location
2734 BEAVER RUN BLVD UNIT D
MYRTLE BEACH
SC
295755392
Practice Location Phone/Fax
| Phone: | 8436501085 |
| Fax: |
Provider Mailing Location
2734 BEAVER RUN BLVD UNIT D
MYRTLE BEACH
SC
295755392
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |